Facelift Patient Instructions



Dr. Oren Friedman, M.D.

Director, Facial Plastic Surgery

Facelift Patient Instructions

Pre-operative instructions:

• Please discontinue the following medications two weeks before your planned procedure as they increase the risk of bleeding:

o Aspirin or aspirin-containing products (Excedrin®, Alka-Seltzer®, Pepto-Bismol®)

o Ibuprofen (Advil®, Motrin®)

o Naproxen (Aleve®)

o Vitamin E, Gingko, Garlic, St. Johns Wort or other herbal supplements that may increase bleeding

You may safely use Tylenol for pain control if needed. Please notify Dr. Friedman’s office if you are currently taking warfarin (Coumadin®) or clopidogrel (Plavix®). Check with your prescribing physician or cardiologist regarding the safety of you coming off these medications before planning surgery.

• If you use tobacco products, please refrain from using tobacco products and avoid exposure to secondhand smoke for at least six weeks prior to your procedure as tobacco products decrease the blood flow to the skin and may compromise the healing process.

• Do not eat or drink anything after midnight the night before your procedure.

Post-operative instructions:

Anesthesia Your procedure will most likely be done under general anesthesia. You will need to have someone drive you to and from the hospital on the day of your procedure. If you have general anesthesia, you may feel fatigued for a couple of days following the procedure.

Swelling and bruising There will be a moderate amount of swelling and bruising following your procedure. You should not drive if the swelling is obstructing your vision nor if you are taking pain medication. You may use ice packs as needed for swelling and bruising, 20 minutes on then 20 minutes off for the first 72 hours after surgery. You should attempt to ambulate as early as possible after the procedure since lying in bed can worsen the swelling. You may need assistance when ambulating for the first 24-48 hours after surgery due to swelling. When lying down, it may be helpful to elevate the head of the bed for at least one week. The swelling will subside slowly each day. You may also experience alterations in your sensation over the forehead and scalp, such as numbness or tingling. This is due to the disruption of nerves during the procedure. This is temporary and should resolve over the next few months. If you develop sudden increase in swelling or pain, especially in the first 24 hours following your surgery, seek immediate medical care by contacting the office immediately or going to the emergency room, whichever is quicker. You might have a hematoma that needs to be drained urgently.

Wound care After your procedure, you may have a pressure dressing over your head which will be examined the next day and will remain in place for one week. After the first week, you should wear the dressing at night for an additional week and during the day as much as possible. All sutures are dissolvable and there is no need for suture removal. If staples are present, they will need to be removed in two weeks. You will be given a prescription for Bacitracin® ointment to be used on your incision sites. Please apply the Bacitracin® ointment to the incisions twice daily for three weeks. If you should develop crusting over the incision sites, please cleanse gently with soap and water. Please take extra care to avoid sun exposure until the wounds are healed and then protect the incision sites with sunscreen as sun exposure can interfere with the healing process. Wear a hat and sunscreen when you are outside for the first 6 months and beyond.

Activities Please ambulate as soon as possible following your procedure to avoid swelling that is worsened from lying down and to prevent the formation of blood clots. You may return to your daily activities in approximately two weeks. You should avoid heavy lifting (greater than 10 lbs) or strenuous exercise for at least two weeks. Although it varies from one individual to the next, you will typically be able to return to work 2 weeks following your procedure.

Medications In addition to prescriptions for Bacitracin® ointment you will also receive prescriptions for narcotic pain medication and an antibiotic. You may use Tylenol® for mild discomfort. Again, please avoid any analgesics that may promote bleeding (see pre-op instructions). If Tylenol® does not adequately control your pain; you may utilize the prescription pain medication. Please note that the prescription pain medication is a Tylenol®-containing product and the maximum dose of Tylenol® is 3 grams (3000mg) in a 24-hour period. You should not drive while taking narcotic pain medication. You should complete the entire course of the antibiotic. Eating yogurt with active cultures may minimize the likelihood of developing diarrhea. If you should develop diarrhea, please stop taking the antibiotic and call Dr. Friedman’s office at 215-829-5180, or call the Hospital operator at 215-829-3000 and ask to be connected to the ENT on-call physician, or go directly to the emergency room.

Complications Please monitor for signs of infection including redness, worsening pain and tenderness to touch, an increase in swelling or purulent (pus) drainage from the incision site. Please notify Dr. Friedman’s office promptly at 215-829-5180 for any persistent bleeding at the incision sites or intense, escalating pain, and if no one is available please go to the emergency room for these problems.

Follow-up appointment You will have a follow-up appointment with Dr. Friedman or Dr. Friedman’s assistant the day following your procedure to evaluate all the incisions and dressings. If you did not schedule an appointment for that, please call Dr. Friedman directly.

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